[Urea-chlorine-water index in stomach neoplasms and stomach precancerous conditions].
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A case of the female patient with gastric carcinoma with metastases into lymph nodes and vertebrae is presented. Generalized DIC with subarachnoid haemorrhage confirmed by CSF examination has occurred in the course of the disease. Applied treatment failed.
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The carcinogenic potential of 1-hydroxyanthraquinone (HA), a naturally occurring compound, was examined. A total of 60 male ACI/N rats, 1.5 months old at the commencement were divided into two groups. Group 1 (30 rats) were fed the diet containing HA at a concentration of 1% throughout the experiment (480 days). Group 2 (30 rats) served as the control given a basal diet alone. Twenty-five of 29 effective animals in group 1 developed adenomas or adenocarcinomas in the cecum or upper portion of the colon, the mean number of large bowel tumors/tumor bearing rat being 2.3. In addition to these intestinal tumors, liver neoplasms (neoplastic nodules and hepatocellular carcinomas) were observed in 12 rats and benign stomach tumors were obtained in five animals; no rats of group 2 demonstrating development of any of these tumor types. The incidences of the large bowel, liver and stomach neoplasms in group 1 were all significant as compared with group 2 (P less than 2 x 10(-13), P less than 5 x 10(-5) and P less than 3 x 10(-2) respectively) clearly indicating that HA is carcinogenic in rats.
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In Japan a better prognosis of gastric cancer has been achieved by early diagnosis and wide, careful lymphectomy. This is not true in western countries. Thus the Authors believe that rational surgical strategy and the careful use of advanced diagnostic tools would produce a better outcome. The Authors report the new diagnostic methods that they adopt in every case of gastric neoplasm: endoscopic ultrasonography, which also proved useful in submucosal tumors, like lymphomas; parenteral nutrition, immune status assessment for a possible use of immune response modulators, single-dose antimicrobial prophylaxis, antithrombotic prophylaxis, autologous blood storage, in order to reduce transfusion-linked risks. Surgical strategy is also reported, which includes wide resection with adequate margins, R2 lymphectomy and intraoperative assessment of disease extension by ultrasonography.